Provider Demographics
NPI:1184785339
Name:HARTZ, JULIE DIANE (MS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:DIANE
Last Name:HARTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 MENDOCINO AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3631
Mailing Address - Country:US
Mailing Address - Phone:707-566-5201
Mailing Address - Fax:707-566-5203
Practice Address - Street 1:3333 MENDOCINO AVE STE 240
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3631
Practice Address - Country:US
Practice Address - Phone:707-566-5201
Practice Address - Fax:707-566-5203
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU847231H00000X
CAHA2074237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter